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Cheers - AE

Thursday 30 July 2009

No easy way out.

It's not often I disagree with the Ambush Predator, and not because of the teeth and claws but because I usually find myself nodding at what she has to say. But while I was picking though the bones outside her cave I found something that she's left some meat on.
"Life clocks are a lie! Carousel is a lie! There is no renewal!"
Much kudos for the Logan's Run reference there, O feasome toothed one. This is going to be about the state offing old people then, yes?

Er... actually, no. Not really.
Mixed feelings about this move:
The Royal College of Nursing is to meet Scottish MP Margo MacDonald to discuss proposals on legalising assisted suicide after the organisation dropped its five-year opposition to the policy.
I might be taking this a little too literally, but that sounds like nothing more than a professional body representing nurses no longer supporting the state preventing people who want to end their lives from doing so with expert assistance.
It seems there’s a movement afoot to ‘normalise’ this, supported by polls:
The move comes as a poll found that 74% of people want doctors to be allowed to help terminally ill people end their lives.

The survey in today's Times found that six out of 10 people said they wanted friends and relatives to be able to help their dying loved ones to take their own lives, without fear of prosecution.
When the alternative for most is likely to be a drawn out and miserable, and possibly painful, ending on the NHS is it surprising? I suspect the fear of being dead is now smaller than the fear of the process of dying, but also that people are starting to want the ultimate - in more ways than one - control of their lives.
However, while I can’t say that I think those who take their relatives abroad to Dignitas should be prosecuted (far from it)...
Excuse the interruption because that point is not black and white. As I mentioned in a comment at Julia's, we would currently expect an investigation if there was good reason to believe that someone jumped off a bridge at the urging of grasping relatives who wanted Gran's money early or freedom from the hassle of looking after her or whatever, and if there was evidence we'd expect a prosecution as well. There is no reason this should not be applied to someone who was coerced into getting on the plane and going to Dignitas, and in that respect the law shouldn't change. But it certainly should stop routinely going after the grieving relatives of someone who has chosen to end their life of their own free will and has asked for help in doing so. The law simply should not have anything to do with that decision unless there is reasonable suspicion of coercion.

I doubt Julia and I actually disagree here and imagine that she'd still want someone prosecuted for buying the Olds a one way ticket to Switzerland and dragging them out of a bridge game and onto the plane against their will. I'm more clarifying where I stand on this point than having a pop at Julia.
... I’m wary of this becoming the norm. And I’m not alone.
The Christian Nurses and Midwives organisation said today it regretted the RCN's policy shift. Secretary Steve Fouch said it sent out the wrong signals "at a time when there is growing anxiety about how we will care for the elderly and severely disabled in the future".
Their statement will be pooh-poohed as ‘religious scaremongering’.
Not necessarily religious scaremongering, but certainly religiously influenced thinking. Couple of points here. First, without wanting to go on about invisible sky fairies or sound like Richard Dawkins when a group of people believe something is Holy Writ you simply cannot have a rational debate with them about it. This is a deal breaker for most Christians, something that they'd see as quite un-Christian to support. Fair enough. I don't think they should support homosexuality either when their Holy Book tells them not to, but nor should they get in the way of those who are gay or those who want an assisted walk towards the light. Second point is that I think the Christian Nurses mob are attacking a straw man by talking about growing anxiety over aged and disabled care in the future. There is indeed anxiety about it in the UK because it's largely state provided and the fund, if you choose to dignify it by calling it such, is well and truly fucked. But the fear that legal assisted suicide will be offered as an alternative to increasing poverty and misery and despair is illogical when suicide is always going to be an option anyway for the majority who are physically able to take it. Naturally they'd be forced to use methods that tend to be crude and messy rather than being offered something that will send them to sleep and prevent them from waking up again, but the point is that when Britain can't afford to care for pensioners and the disabled in a humane way because of the Ponzi scheme that NI has always been some will choose suicide over slowly starving and freezing to death anyway. All that would be changed by allowing assisted suicide is that those who want out but are unable to take their own lives because of disability or because they left it until they were too frail have the same choice as those who are more physically able. In some respects it's like putting in a wheelchair ramp to the shops so everyone can go, except of course that those who do won't be coming back.
...a glance across the Channel to the continent will show this has already been experienced in the Netherlands:
Euthanasia critics have talked about the "slippery slope" as a possibility; in the Netherlands, it is a fact.

Many old people now fear Dutch hospitals. More than 10% of senior citizens who responded to a recent survey, which did not mention euthanasia, volunteered that they feared being killed by their doctors without their consent. One senior-citizen group printed up wallet cards that tell doctors that the cardholder opposes euthanasia.
Is this just panic and scaremongering?
Well, I wouldn't call it an entirely rational fear, though not entirely irrational either given what this guy did. But since the survey specifically didn't mention euthanasia the 10% who fear their doctor killing them may not be afraid they'll be euthanized so much as murdered for more prosaic reasons. There is also the point that elderly people suffering from dementia can be a bit paranoid sometimes (I have personal experience of this though fortunately we see far more good days than bad ones). Needless to say dementia patients who are too far gone to be able to make a rational decision shouldn't even be in consideration for assisted suicide. Also euthanasia will probably remain illegal since it doesn't necessarily imply consent of the one being euthanized, whereas assisted suicide does. I feel the distinction is quite an important one and not just semantics. The whole issue after all is about individual choice.
Can it be dismissed as ‘something that can’t happen here’?

Well, we are on the right road to it:
What makes the Dutch comfortable with euthanasia? One factor is that their doctors became comfortable with it. "The Dutch have got so far so fast because right from the beginning, they have had the medical profession on their side," Derek Humphrey, founder of the Hemlock Society, told the Toronto Globe and Mail last September. "Until we get a significant part of the medical profession on our side, we won't get very far."
Have the Dutch got so far particularly fast? I think that's a matter of opinion. We could just as easily say that the Dutch have simply been less slow than everybody else. In any case it seems inapplicable to the UK where, according to those surveys, the majority of British people are way ahead of the doctors in becoming comfortable with it. To repeat what I said at the beginning, all that is happening is that one, aha, body in the medical profession no longer supports the state actively obstructing assisted suicide. That's it, and I'd hardly say it qualifies as having the medicos on side.
So, how has this gained such a grip on the doctors?

Glad you asked:
How did Dutch doctors change their thinking so dramatically in the space of one lifetime?

The path to the death culture began when doctors learned to think like accountants. As the cost of socialized medicine in the Netherlands grew, doctors were lectured about the importance of keeping expenses down.

In many hospitals, signs were posted indicating how much old-age treatments cost taxpayers. The result was a growing "social pressure" from doctors and others, says Arno Heltzel, a spokesman for the Catholic Union of the Elderly, the largest Dutch senior-citizen group, which favors voluntary euthanasia. "Old people have to excuse themselves for living. When they say that all of their friends are dead, people say, 'Maybe it is time for you to go too,' rather than, 'You need to find new friends.' "

I bet NICE has some of those posters ready to go to the printers already…
I'm no fan of the grossly inappropriately named NICE* and wouldn't put much past them. But given that this comes from a spokesman for a Catholic organisation I have to wonder if there's a little bias in there. In fact the emotionally charged phrase "path to death culture" makes me wonder about bias in the whole article.

However, I do concede that British doctors are forced to think like accountants, or more probably are actually controlled by accountants. And obviously from a cost point of view there's a lot to be said for encouraging the old and sick and disabled to save a few bob for the increasingly cash strapped state, stuck with the consequences of its own NI Ponzi scheme, by holding their breath for the next 20 billion years. But as I said above, suicide is an option right now so the state can already drive people towards it to save money. It could be argued that it in fact it's already done so in the past and continues to this day, though more through ineptness and stupidity rather than as a deliberate aim. Still, the point is that I don't think the availability of a comfortable assisted suicide is going to change much when the pensions cesspool hits the fan because in the absence of a Dignitas style option I expect orderly queues to form at bridges and cliff tops instead.

All the same I don't trust the government as far as I could throw it and have used pretty much this same lack of trust and thin end of the wedge argument against letting the state bring back capital punishment (or retain it where it already exists), and I argued it with the Ambush Predator herself when we discussed it here and here. It's ironic that Julia is now making a similar argument to me opposing assisted suicide. We're both using the same argument to oppose deliberate action to cause death, and on both occasions we're taking opposing sides of the argument. But as I said in the comments to Julia's "Carousel" post, if you trust the government not to abuse the power to execute criminals why not also trust them on assisted suicide? Equally I could be asked why I distrust the government on execution but support assisted suicide, and the answer is because I don't think it's the same thing anyway. Again, I want to make assisted suicide distinct from euthanasia - one implies choice and the other does not**. Aside from the fact that the British government lacks the balls to kill murderers and rapists and therefore seems unlikely to have an appetite for wasting grannies, we're not actually talking about giving the state more power anyway. Quite the reverse, we're talking about taking away the power to obstruct that it already has. Fundamentally I believe that people own their bodies and when they don't want to use them anymore they should be able to seek expert help. I'm not saying the state should provide the service. In fact for the reasons Julia mentions, and for the reasons I oppose the state having the power of execution, I'd say it certainly should not provide the service. It shouldn't even ensure that anyone does. It should simply keep out of the way of rational adults who wish to end their lives without resorting to the crude options that are mostly all that's available to them now. In other words, if I should actively choose to die at some point in the future, rather than sticking the end of my Beretta in my mouth and trying to reach the trigger or traumatizing a train driver by jumping in front of his office I ought to be free to look for someone with the medical know how to send me into the forever in a state of supreme fluffiness***. And providing there is no suggestion that I was coerced this should be absolutely no concern of the government. It should be a decision made by one individual and a service provided by one or more others, a transaction for a song sheet and seat in the Choir Eternal. It should be much the same as buying a car or a computer except that presumably you won't come back to life three months out of warranty or have to pay extra for the essential update to Decomposition 2.0.

In short, and as usual, what I want is more freedom. Our bodies and lives are our own, and whether we choose to end them ourselves or to seek assistance should be no business of the state unless there is a good reason for thinking it might not have been entirely voluntary. That aside the state should fuck off and leave us all alone.


* I've long suspected NICE is also an example of coming up with the acronym first and then finding a vaguely relevant name that fits the acronym. Given the often not nice nature of NICE we might as well change it to the Clinicians' Unit for Nationwide Treatment, and yes I did come up with the name the same way.
** Doesn't necessarily imply coercion either. I'm just saying that someone can choose to be euthanized OR someone can be euthanized regardless of choice, as opposed to an assisted suicide which by definition strongly suggests a decision to end one's own life. Suicide that comes as a result of coercion would be suicide in name only and in practice more like euthanasia, or possibly even murder.
*** I might not be able to find anyone, but that's not a concern of the government either.

2 comments:

JuliaM said...

"Much kudos for the Logan's Run reference there..."

Heh! For a film buff, what else? Mind you, the original novels are so much better.

Actually, it's one film that's overdue a remake too. Keep to the plot in the novels and there's so much scope...

"But it certainly should stop routinely going after the grieving relatives of someone who has chosen to end their life of their own free will and has asked for help in doing so."

Absolutely agree. Especially this chap. Though I can see how the cops might have got twitchy in retrospect, in case he planned another Hungerford instead...

"...when a group of people believe something is Holy Writ you simply cannot have a rational debate with them about it."

The problem is, you can believe in the uniqueness of human life, and the desire to NOT see it cheapened, without being religious.

But we all get tarred with the religious brush by those with hidden agendas. It's a problem..

"In short, and as usual, what I want is more freedom. Our bodies and lives are our own, and whether we choose to end them ourselves or to seek assistance should be no business of the state unless there is a good reason for thinking it might not have been entirely voluntary."

This is certainly the heart of the matter, whatever side you are on - and I increasingly thinks there's no longer two 'sides', but merely multiple angles...

Good to see more debate about it though! It's always been a topic to avoid. We've conquered our hangups about sex (not always to advantage, admittedly), why not conquer our hangups about death?

Angry Exile said...

Very good example you've linked to there.

The problem is, you can believe in the uniqueness of human life, and the desire to NOT see it cheapened, without being religious.
Indeed, but then that's being rational rather than taking a position because a book, or at least one translation of a translation of a translation or something, says that everyone must take a certain position.

Personally I think religious viewpoints can easily cheapen life. The view that life is not one's own but belongs to some supernatural being who gives it and takes it away again at will does so if you ask me. So does the idea of an afterlife for which you've got to earn points for some kind of spiritual loyalty card. That sort of thing has lead to people putting a value on life where killing for God makes sense, including killing oneself in the process. I'll stop there before I turn into Richard Dawkins.

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